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http://dx.doi.org/10.3340/jkns.2011.49.1.75

A Case of Pedicle Screw Loosening Treated by Modified Transpedicular Screw Augmentation with Polymethylmethacrylate  

Kang, Suk-Hyung (Department of Neurosurgery, College of Medicine, Chung-Ang University)
Kim, Kyoung-Tae (Department of Neurosurgery, College of Medicine, Chung-Ang University)
Park, Seung-Won (Department of Neurosurgery, College of Medicine, Chung-Ang University)
Kim, Young-Baeg (Department of Neurosurgery, College of Medicine, Chung-Ang University)
Publication Information
Journal of Korean Neurosurgical Society / v.49, no.1, 2011 , pp. 75-78 More about this Journal
Abstract
We report a case of pedicle screw loosening treated by modified transpedicular screw augmentation technique using polymethylmethacrylate(PMMA), which used the anchoring effect of hardened PMMA. A 56-year-old man who had an L3/4/5 fusion operation 3 years ago complained of continuous low back pain after this operation. The computerized tomography showed a radiolucent halo around the pedicle screw at L5. We augmented the L5 pedicle screw with modified pedicle screw augmentation technique using PMMA and performed an L3/4/5 pedicle screw fixation without hook or operation field extension. This modified technique is a kind of transpedicular stiffness augmentation using PMMA for the dead space around the loosed screw. After filling the dead space with 1-2 cc of PMMA, we inserted a small screw. Once the PMMA hardened, we removed the small screw and inserted a thicker screw along the existing screw threading to improve the pedicle screws' pullout strength. At 10 months' follow-up, x-ray showed strong fusion of L3/4/5. The visual analogue scale (VAS) of his back pain was improved from 9 to 5. This modified transpedicular screw augmentation with PMMA using anchoring effect is a Simple and effective surgical technique for pedicle screw loosening. However, clinical analyses of long-term follow-up and biomechanical studies are needed.
Keywords
Instrument failure; Osteoporosis; Pedicle screw loosening; PMMA; Pseudoarthrosis; Surgical technique;
Citations & Related Records
Times Cited By KSCI : 2  (Citation Analysis)
Times Cited By Web Of Science : 0  (Related Records In Web of Science)
Times Cited By SCOPUS : 0
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